Adequate safety and improvement in symptom burden seen with self-administered home biologic therapies for the management of severe asthma and chronic rhinosinusitis with nasal polyps suggest potential for shifting care farther afield. more expensive hospital setting.
According to the results of a study published in Chest.
As 2 common inflammatory-mediated diseases, both asthma and CRSwNP have been associated with a high economic burden that increases further when the conditions are comorbid. A prior analysis of outpatient and inpatient service costs for CRSwNP in Poland indicated that inpatient services accounted for the majority of the total cost of the condition.
For asthma, severe disease affects a minority of patients, but increased severity has been shown to further increase asthma burden and is associated with high human and economic costs.
Biological treatment resulted in reduced use of healthcare resources (hospitalizations and prescriptions for oral corticosteroids) for severe asthma. However, research has shown that the economic burden of severe, uncontrolled asthma remains high despite treatment with biologics.
As a potential alternative to more expensive hospitalization, the authors of this study sought to analyze the compliance and clinical response associated with self-administration of a biological treatment at home in a group of patients with severe asthma. and CRSwNP.
Ten patients with severe asthma (stage 5 of the Global Asthma Initiative guidelines) and CRwNP receiving biological therapy in the outpatient department of the Pulmonary Department of Azienda Sanitaria Ligure, La Spezia, Italy, were included in the analysis. Participants were trained on how to self-administer when they received the first biologic injection at the clinic and then transitioned to self-administering at home.
“They could communicate to a dedicated nurse any adverse events or questions. The Asthma Control Test (ACT), Severe Asthma Questionnaire (SAQ), and Sino-Nasal Outcome Test (SNOT-22) were performed at baseline and after 3 months,” the researchers said. .
Home self-administration included the biologics mepolizumab (n=4), dupilumab (n=3), omalizumab (n=2), and benralizumab (n=1), with all patients performing as expected.
At baseline, the mean ACT score was 8.8, the SAQ was 177.9, and the SNOT-22 score was 34. Improvements were seen for all 3 measures at a 3-month follow-up, with an ACT score of 23.7, an SAQ score of 340.3, and an SNOT-22 score of 6.
“Self-administration of biologics at home is safe; patients had good compliance and improved symptoms,” the study authors concluded. “Our study suggests the importance of dedicated pathways in chronic disease management at home to shift the burden of care to the outpatient setting.”
Fui A, Fini D, Sivori M. Self-administration of biological therapy in severe asthma and chronic rhinosinusitis with nasal polyps: compliance and improved quality of life. Chest. Published online June 20, 2022. doi:10.1016/j.chest.2022.04.121